| NPI | 1972131316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 71094) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MS 35298) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-12-12 |